A hybrid endoscopic technique to close tracheoesophageal fistula

Tracheoesophageal fistula (TEF) is a congenital or acquired pathologic entity characterized by an abnormal communication between the posterior aspect of the trachea and the anterior wall of the esophagus. Acquired TEF is a not uncommon adverse event secondary to mechanical ventilation, trauma, esophageal tumor, prior laryngectomy, or esophagectomy.1-3 Given the potential serious consequence of possible fatal pulmonary aspiration, prompt closure of TEFs is critical. Although an endoscopic approach to TEFs has been optimized over the past years, including endoscopic stent placement and over-the-scope clip system,4-5 recurrent TEFs remain a therapeutic challenge, with literature reporting up to 20% recurrence.